Provider Demographics
NPI:1346654480
Name:HULAN, AMY
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:HULAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 SE LILLY AVE
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97333-1814
Mailing Address - Country:US
Mailing Address - Phone:541-740-1506
Mailing Address - Fax:
Practice Address - Street 1:230 SW 3RD ST
Practice Address - Street 2:#301
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97333-4692
Practice Address - Country:US
Practice Address - Phone:541-740-1506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-17
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional